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_____ZONING HEARING BOARD APPLICATION
_____TECHNICAL REVIEW BOARD APPLICATION
1. Applicant Name:______
Phone Number:______
Mailing Address:______
______
If Applicant is not the property owner, state Applicant’s Authority to Title or Interest to bring this Application (Equitable Owner, Agent, Lessee, etc.)______
2. Agent:______
Phone Number:______
Mailing Address:______
3. Property Owner:______
Phone Number:______
Mailing Address:______
______
4. PropertyTax Map Parcel Number: ______
Property Physical Address:______
Present Zoning District and Classification:______
Present Use:______
Lot Dimensions:______
5. The Applicant hereby:
_____Appeals an action of the Zoning Officer
_____Requests a Special Exception
_____Requests a Variance
_____Challenges the validity of the Joint Municipal Zoning Ordinance (JMZO) or Map
_____Wishes a Unified Appeal in Accordance with the Municipalities Planning Code Section 913.1
6. Failure to submit the following items with this application constitutes an incomplete application that will be rejected.
- _____Copies of this application including all drawings and documentation
- Application MUST BE Notarized
- Applicable Application Fee of $______
- Separate Continuance Fee of $______
- Copy of the Present Deed
- A complete list of names and mailing addresses of all properties within 500 feet of the subject parcel
7. Description of Premises:
Present Use:______
______
Proposed Use/Improvements:______
______
8. Prior Zoning Appeals, Variances, Special Exceptions Relating to this Property? Yes______No______
If yes, indicate Date and Nature of Zoning Granted:______
______
9. FOR APPEAL FROM ACTION OF ZONING OFFICER:
A. Action Being Appealed:______
______
B. Date of Action Taken:______
C. The Foregoing Action was believed to be in error because:______
______
______
10. FOR REQUEST FOR SPECIAL EXCEPTION:
A. Nature of Exception Sought:______
______
B. The Exception is Allowed under Section ______of the JMZO.
C. If more than one Special Exception is requested, List ALL Pertinent Ordinance Sections and the Nature of each Exception sought. This may be submitted on additional paper.
11. FOR REQUEST OF VARIANCE:
A. Nature of Variance Sought:______
______
B. The Variance is from Section ______of the JMZO
C. If more than one Variance is requested, List ALL Pertinent Ordinance Sections and the Nature of each Variance sought. This may be submitted on additional paper.
D. The Nature of the Unique Circumstances and Unnecessary Hardship Justifying the Variance:______
______
______
______
12. FOR CHALLENGE TO ZONING ORDINANCE AND/OR MAP
A. The Ordinance and/or Map Challenge is as Follows:______
______
______
______
B. The Challenge is Ripe for Decision Because:______
______
______
______
C. The Ordinance/Map Challenged is Invalid Because:______
______
______
______
13. FOR UNIFIED APPEAL UNDER MPC SECTION 913.1, COMPLETE ALL SECTIONS ABOVE THAT MAY BE APPLICABLE TO THE ZONING QUESTION(S) FOR CONSIDERATION. ALSO COMPLETE THE FOLLOWING:
A. The Development or Development Plan is Designated as Follows:______
______
______
B. The Non-Zoning Issue(s) about which Testimony will be Presented are:______
______
______
SIGNATURE OF APPLICANT/AGENTSIGNATURE OF OWNER
______
Application Fee:______
Check #: ______
Continuance Fee: ______
Check #: ______
Submission Date:______
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ______
THE UNDERSIGNED, BEING DULY SWORN ACCORDING TO LAW, DEPOSES AND SAYS THAT HE/SHE IS THE ABOVE NAMED APPLICANT; THAT HE/SHE IS AUTHORIZED TO AND DOES TAKE THIS AFFIDAVIT ON BEHALF OF THE OWNER, AND THAT THE FACTS HEREIN CONTAINED ARE TRUE AND CORRECT.
SIGNATURE OF APPLICANT
______
SWORN TO AND SUBSCRIBED
BEFORE ME THIS______
DAY OF ______, 2002.
______
NOTARY PUBLIC
ZONING OFFICER______DATE______